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General NPI Number Information
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NPI Number | 1932197076
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Entity Type | Individual
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Provider Name | MALVINDER S AJIT MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3209 PLEASANT HILL RD
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City | LYNN HAVEN
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State | FL
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Zip | 32444-5651
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Country | US
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Telephone | 850-227-8450
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Fax | 850-271-9659
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Provider Business Mailing Address
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Address Line | 3209 PLEASANT HILL RD
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City | LYNN HAVEN
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State | FL
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Zip | 32444-5651
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Country | US
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Telephone | 850-227-8450
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Fax | 850-271-9659
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME76922
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License Number State | FL
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